Effects of oral health-related quality of life on total mortality: a prospective cohort study

Nishiki Arimoto; Rumi Nishimura; Teruo Kobayashi; Mayuka Asaeda; Toru Naito; Masaaki Kojima; Osami Umemura; Makoto Yokota; Nobuhiro Hanada; Takashi Kawamura; Kenji Wakai; Mariko Naito

doi:10.1186/s12903-023-03451-8

Effects of oral health-related quality of life on total mortality: a prospective cohort study

BMC Oral Health. 2023 Oct 3;23(1):708. doi: 10.1186/s12903-023-03451-8.

Authors

Affiliations

¹ Department of Oral Epidemiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan. n.arimoto13@gmail.com.
² Department of Oral Epidemiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
³ Department of Dentistry and Oral Surgery, Asahi General Hospital, Asahi, Chiba, Japan.
⁴ Department of Oral Health, Faculty of Health Sciences, Kobe Tokiwa University, Kobe, Hyogo, Japan.
⁵ Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka, Japan.
⁶ Aichi Dental Association, Nagoya, Aichi, Japan.
⁷ Yokota Makoto Dental Clinic, Fukuoka, Japan.
⁸ Photocatalysis International Research Center, University of Shanghai for Science and Technology, Shanghai, P.R. China.
⁹ Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan.
¹⁰ Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.

Abstract

Background: The effects of oral health on mortality have been reported; however, the association between mortality and Oral Health-Related Quality of Life (OHQOL) is unknown. We investigated the effect of OHQOL on total mortality in a cohort consisting of dentists.

Methods: In this cohort study, we analyzed data from the Longitudinal Evaluation of Multi-phasic, Odonatological and Nutritional Associations in Dentists study. We conducted a baseline survey of general and oral health factors. We called for 31,178 participants and collected responses from 10,256 participants. We followed up with 10,114 participants (mean age ± standard deviation, 52.4 ± 12.1 years; females, 8.9%) for 7.7 years, until March 2014, to determine the average total mortality. OHQOL was assessed using the General Oral Health Assessment Index (GOHAI). The total score was divided into quartiles (Q1 ≤ 51.6, Q2 = 51.7-56.7, Q3 = 56.8-59.9, and Q4 = 60.0), with higher GOHAI scores indicating better OHQOL (score range, 12-60). The association between OHQOL and total mortality was analyzed using the Cox proportional hazards model.

Results: We documented 460 deaths. Males with low GOHAI scores possessed a remarkably high risk of total mortality. The multivariate adjusted-hazard ratios (aHRs), were 1.93 (95% confidence interval [CI], 1.07 - 3.48) for Q1, 1.69 (95% CI, 0.90 - 3.17) for Q2, and 0.65 (95% CI, 0.29 - 1.46) for Q3, relative to Q4 (trend p = 0.001). The aHRs in the multivariate model with all background variables were 1.69 (95% CI, 1.15-2.46) for Q1, 1.53 (95% CI, 1.04-2.27) for Q2, and 1.09 (95% CI, 0.71-1.70) for Q3, relative to Q4 (trend p = 0.001). In females, there was no significant association between the quartiles, in both the multivariate-adjusted model (trend p = 0.52) and multivariate-adjusted model with all background variables (trend p = 0.79).

Conclusions: A lower OHQOL indicated an increased risk of total mortality in dentists. OHQOL may be used as an indicator for selecting treatment plans and personalized care interventions, thus contributing to increased healthy life expectancy.

Trial registration: Aichi Cancer Center, Nagoya University Graduate School of Medicine, and Hiroshima University (Approval numbers: 33, 632-3, 8-21, and E2019-1603).

Keywords: OHQOL; Oral health; Oral health-related quality of life; QOL; Quality of life; Total mortality.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cohort Studies
Female
Humans
Male
Oral Health*
Prospective Studies
Quality of Life*